World Health Organization Requirements Research Articles

Pengembangan Seni Hidangan Alternatif dan Terinspirasi pada Kader Posyandu Balita Sesuai Kandungan Gizi Isi Piringku di Desa Karangsono Kabupaten Jember

Stunting poses a serious health issue in Indonesia. In 2022, the national prevalence of stunting stood at 22.6%, exceeding the World Health Organization's requirement of below 20%. According to the Indonesian Nutrition Status Survey (SSGI) 2022 by the Ministry of Health, Jember Regency has the highest prevalence of stunted toddlers in East Java, reaching 34.9% or approximately 35,000 toddlers. To address the stunting problem, health efforts are being made through the prevention of stunting diseases with the implementation of the "SEHATI" (Seni Hidangan Alternatif dan Terinspirasi or Alternative or Inspired Food Art) program in Karangsono Village, Bangsalsari Subdistrict, Jember Regency. This program involves community health volunteers managing meals according to the "Isi Piringku" guidelines with appropriate nutritional content for toddlers. The aim of this activity is to raise awareness and knowledge among community health volunteers about the importance of managing balanced and nutritious meals according to the "Isi Piringku" program issued by the Ministry of Health. This study uses a Pre-Experimental Design method with a Pretest-Posttest design model to measure the increase in knowledge of community health volunteers after socialization about the "Isi Piringku" program. The research results show that 90% of volunteers experienced an average knowledge increase of 13.5 after the counseling activities. The "SEHATI" program successfully stimulates children's appetite through unique and appealing foods with balanced nutritional value. The "SEHATI" program is expected to serve as an example for the community in preparing balanced and nutritious meals for children. Through accurate and easily understandable nutrition education, it is hoped that awareness of the importance of healthy and nutritious food intake will increase, ultimately aiding in the prevention of stunting and other nutritional problems in Jember Regency.

Evaluation of drug use pattern in adults’ outpatient clinics in a tertiary teaching hospital using WHO core prescribing indicators

Abstract Objectives This study has evaluated the drug use pattern among adults attending the outpatient clinics of the Jordan University Hospital (JUH), by assessing the adherence of prescriptions to the World Health Organization (WHO) core prescribing indicators. Methods This is a cross-sectional study that was conducted during the period from October 2011 to January 2022 at JUH. Several prescriptions from 10 different adult outpatient clinics were reviewed to evaluate hospital adherence to the five WHO core prescribing indicators. Key findings To assess the WHO core prescribing indicators, data for 2451 prescriptions were reviewed. Around one-third of the patients (33.4%) were receiving polypharmacy (five medications or more). Results revealed that two core prescribing indicators were not following the standard values specified by the WHO; the average number of drugs prescribed per encounter (3.8 medications/prescription), and the percentage of drugs from the essential drug list (EDL) (54.1%). Endocrine clinics showed the highest average of drugs (6.3) per prescription and the highest percentage of prescriptions with injectable medicines (51.7%). On the other hand, ophthalmology clinics showed the highest percentage of prescriptions with antibiotics (29.9%) and the lowest percentage of drugs prescribed from the EDL at JUH (14.1%). Evaluating factors affecting the number of prescribed medications per encounter revealed that elderly patients (> 60 years), being female, referring to the endocrine clinic, and having insurance have a higher average number of medications per encounter compared with others (P < 0.05). Conclusion The proper prescribing practices in a sizable tertiary hospital in Amman, Jordan, are clarified by this study. The percentage of medications from EDL and the typical number of drugs/encounters did not comply with WHO requirements. The study findings should guide the Jordanian health policymakers in designing and implementing strategies to limit irrational prescribing practices and raise awareness of and ensure physician adherence to the national EDL.

Investigation of Physiochemical Properties of Groundwater at Estako-West, Edo-North, Nigeria

The physicochemical parameters of groundwater at Auchi and South-Ibie were investigated to determine underground water quality in this environment. Water sampled locations in Auchi were categorized as Iyekhei (Iyekhei), Auchi Poly Water (Auchi PW), Auchi Poly Hostel (Auchi PH), Double Delight Hostel (DDH); South-Ibie locations are Levis Gas Plant (LGP), Pastoral Centre (PC), Global Castle Hostel Sawmill Road (GCHS), Arsenal Hostel and, Lagos Street (AHLS). A total number of 80 water samples from eight locations were collected and analyzed using some statistical metrics to determine the relationship among measured parameters. The pH of water samples ranged from 1.4 at GCHS to 4.12 at AHLS. The result indicated that all the investigated water samples have low pH values with a high alkalinity level. Total dissolved solids (TDS) of 300mg/L, 400mg/L, and 500mg/L were obtained from the water samples at Iyekhei, Auchi PH, and DDH. These values are within the allowable World Health Organization (WHO) standard. However, the chloride level for all locations was very high except for Iyekhei, with a value of 115 mg/L, which is accepted within the WHO requirement of 250 mg/L. Conductivity values of four sampled water locations; namely, Auchi PH, DDH, PC, and GCHS, are within the allowable limit. High conductivity values of 304 sm/cm, 116.7sm/cm, and 845 sm/cm were obtained for LGP, Auchi PW, Iyekhei, respectively. All the water sampled locations’ results indicated that none of the sampled water is within the WHO required standard of 20oC to 23oC. The statistical metrics showed a strong relationship between the conductivity and chloride concentration with R2=0.7174; this may be related to some dissolved conductive ions in the water sampleThe research study’s output is imperative to understand the relationship between different groundwater parameters to develop and good groundwater quality.

Risk Assessment of Water Intakes in South-Eastern Poland in Relation to the WHO Requirements for Water Safety Plans

Since 2017, risk assessments for water intakes in Poland have provided the basis for decisions to establish indirect water protection zones. The preventive, risk-based approach and the related risk minimization measures are required under the provisions of the Drinking Water Directive (DWD) of the European Parliament and of the Council of 16 December 2020 on the quality of water intended for human consumption. This approach is in line with the World Health Organization (WHO) recommendations for water safety plans. The aim of this study was to present a methodology and to carry out a risk assessment of the threats to surface water intakes, which in Poland, should be completed by the end of 2022. Risk assessments were performed for four onshore-type surface water intakes located in south-eastern Poland. The results were presented in aggregate form, which enabled clear presentation and conclusions. It was found that the greatest risks are associated with seasonal changes in water quality (mainly high turbidity and water blooms), unregulated sewage management, the occurrence of floodwater flows and catastrophic events caused by the potential failure of wastewater treatment plants. Based on the results of the risk assessment, the need to establish new, or to adjust the existing, protection zones for the analyzed water intakes was identified.

The water incident database (WAID) 2012 to 2019: a systematic evaluation of the documenting of UK drownings

BackgroundDeath by drowning is a leading cause of accidental death in the United Kingdom (UK) and worldwide. The World Health Organization (WHO) states that effective documentation of drowning is required to describe drowning frequency and to underpin effective drowning prevention intervention, thus improving the quality of data describing drowning frequency represents a key initiative. The water incident database (WAID) has been used to document UK fatal and non-fatal water-based incidents since 2009. WAID has not undergone a systematic evaluation of its data or data collection procedures to establish if the database meets the WHO requirements. The present study investigated the characteristics of UK fatal drowning incidents and audited current WAID data capture procedures.MethodsData for the fatal drowning cases recorded between 2012 and 2019 were reviewed. Descriptive data were generated 1) to describe fatal drownings in the UK’s WAID in this period; 2) a sub-set of drownings were audited i) for completeness of data entry and, based on source documents, ii) for quality of data entry; 3) these processes were used to make recommendations for onward revisions to WAID.ResultsA total of 5051 fatalities were recorded between 2012 and 2019. Drowning was most frequent amongst males aged 35 to 60 years (n = 1346), whilst suspected accidents and suicides accounted for 44 and 35% of fatalities. Suicide by drowning was at a peak in the most recent year of data analysed (i.e., 2019; 279 cases) highlighting an urgent need for targeted intervention. Audit part 2i) indicated that 16% of all fields were incomplete, thus indicating potential redundancy, duplication, or the need for onward review. Audit part 2ii) indicated high levels of agreement (80 ± 12%) between audited cases and the ‘true’ WAID entries.ConclusionsThis study confirms WAID as a rigorous, transparent and effective means of documenting UK drownings thereby meeting WHO requirements for data quality; yet future improvements are recommended. Such findings allow researchers and policy makers to use WAID to further investigate UK drowning with a view to improving public safety measures and drowning prevention interventions. Observations alongside several expert recommendations have informed a revised version of WAID.

From the Field to the Laboratory: Quantifying Outdoor Mosquito Landing Rate to Better Evaluate Topical Repellents.

Vector-borne diseases are a worldwide threat to human health. Often, no vaccines or treatments exist. Thus, personal protection products play an essential role in limiting transmission. The World Health Organization (WHO) arm-in-cage (AIC) test is the most common method for evaluating the efficacy of topical repellents, but it remains unclear whether AIC testing conditions recreate the mosquito landing rates in the field. This study aimed to estimate the landing rate outdoors, in an area of Europe highly infested with the Asian tiger mosquito (Aedes albopictus (Skuse, 1894, Diptera: Culididae)), and to determine how to replicate this rate in the laboratory. To assess the landing rate in the field, 16 individuals were exposed to mosquitoes in a highly infested region of Italy. These field results were then compared to results obtained in the laboratory: 1) in a 30 m3 room where nine volunteers were exposed to different mosquito abundances (ranges: 15-20, 25-30, and 45-50) and 2) in a 0.064 m3 AIC test cage where 10 individuals exposed their arms to 200 mosquitoes (as per WHO requirements). The highest mosquito landing rate in the field was 26.8 landings/min. In the room test, a similar landing rate was achieved using 15-20 mosquitoes (density: 0.50-0.66 mosquitoes/m3) and an exposure time of 3 min. In the AIC test using 200 mosquitoes (density: 3,125 mosquitoes/m3), the landing rate was 229 ± 48 landings/min. This study provides useful reference values that can be employed to design new evaluation standards for topical repellents that better simulate field conditions.

Evaluation of Prescribing Pattern in Mirpur Azad Kashmir using who Prescribing Indicators

Promotion of rational use of drugs in developing countries is necessary for improving the quality of life. Therefore, evaluation of drug use pattern using World Health Organization (WHO) indicators is necessary for assessment of rational use of drugs. 200 prescriptions were randomly collected from different pharmacies in Mirpur and evaluated to measure prescribing indicators. Data was analyzed using SPSS (version 25). Average count of drugs prescribed per prescription was 3.8 (S.D+ 2.01). Percentage of antibiotics prescribed, and injections prescribed per prescription was 42% (n=84) and 16% (n=32) respectively. The percentage of drugs prescribed from Essential Drugs List was 90.5%. It was concluded that prescribing pattern was far away from the standard WHO requirements. Greater number of drugs and overuse of antibiotics focused on close monitoring and regulation of prescribing pattern. Steps should be taken to encourage the rational use of drugs to improve the quality of life.

Development and Assessment of Two Highly Pathogenic Avian Influenza (HPAI) H5N6 Candidate Vaccine Viruses for Pandemic Preparedness

ObjectiveIn China, 24 cases of human infection with highly pathogenic avian influenza (HPAI) H5N6 virus have been confirmed since the first confirmed case in 2014. Therefore, we developed and assessed two H5N6 candidate vaccine viruses (CVVs). MethodsIn accordance with the World Health Organization (WHO) recommendations, we constructed two reassortant viruses using reverse genetics (RG) technology to match the two different epidemic H5N6 viruses. We performed complete genome sequencing to determine the genetic stability. We assessed the growth ability of the studied viruses in MDCK cells and conducted a hemagglutination inhibition assay to analyze their antigenicity. Pathogenicity attenuation was also evaluated in vitro and in vivo. ResultsThe results showed that no mutations occurred in hemagglutinin or neuraminidase, and both CVVs retained their original antigenicity. The replication capacity of the two CVVs reached a level similar to that of A/Puerto Rico/8/34 in MDCK cells. The two CVVs showed low pathogenicity in vitro and in vivo, which are in line with the WHO requirements for CVVs. ConclusionWe obtained two genetically stable CVVs of HPAI H5N6 with high growth characteristics, which may aid in our preparedness for a potential H5N6 pandemic.

Automated Respiratory Rate Counter to Assess Children for Symptoms of Pneumonia: Protocol for Cross-Sectional Usability and Acceptability Studies in Ethiopia and Nepal.

BackgroundManually counting a child’s respiratory rate (RR) for 60 seconds using an acute respiratory infection timer is the World Health Organization (WHO) recommended method for detecting fast breathing as a sign of pneumonia. However, counting the RR is challenging and misclassification of an observed rate is common, often leading to inappropriate treatment. To address this gap, the acute respiratory infection diagnostic aid (ARIDA) project was initiated in response to a call for better pneumonia diagnostic aids and aimed to identify and assess automated RR counters for classifying fast breathing pneumonia when used by front-line health workers in resource-limited community settings and health facilities. The Children’s Automated Respiration Monitor (ChARM), an automated RR diagnostic aid using accelerometer technology developed by Koninklijke Philips NV, and the Rad-G, a multimodal RR diagnostic and pulse oximeter developed by Masimo, were the two devices tested in these studies conducted in the Southern Nations, Nationalities, and Peoples’ Region in Ethiopia and in the Karnali region in Nepal.ObjectiveIn these studies, we aimed to understand the usability of two new automated RR diagnostic aids for community health workers (CHWs; health extension workers [Ethiopia] and female community health volunteers [Nepal]) and their acceptability to CHWs in Ethiopia and Nepal, first-level health facility workers (FLHFWs) in Ethiopia only, and caregivers in both Ethiopia and Nepal.MethodsThis was a prospective, cross-sectional study with a mixed methods design. CHWs and FLHFWs were trained to use both devices and provided with refresher training on all WHO requirements to assess fast breathing. Immediately after training, CHWs were observed using ARIDA on two children. Routine pneumonia case management consultations for children aged 5 years and younger and the device used for these consultations between the first and second consultations were recorded by CHWs in their patient log books. CHWs were observed a second time after 2 months. Semistructured interviews were also conducted with CHWs, FLHFWs, and caregivers. The proportion of consultations with children aged 5 years and younger where CHWs using an ARIDA and adhered to all WHO requirements to assess fast breathing and device manufacturer instructions for use after 2 months will be calculated. Qualitative data from semistructured interviews will be analyzed using a thematic framework approach.ResultsThe ARIDA project was funded in November 2015, and data collection was conducted between April and December 2018. Data analysis is currently under way and the first results are expected to be submitted for publication in 2020.ConclusionsThis is the first time the usability and acceptability of automated RR counters in low-resource settings have been evaluated. Outcomes will be relevant for policy makers and are important for future research of this new class of diagnostic aids for the management of children with suspected pneumonia.International Registered Report Identifier (IRRID)DERR1-10.2196/14405

Evaluation of Medication Use Patterns among Geriatric Patients using World Health Organization Prescribing Indicators

Geriatrics patients are paticularly suceptible to medication error due to complex clinical problems and multiple treatment. World Health Organization (WHO) published a set of prescribing indicators to promote rationale use of drug. This study aimed to evaluate medicine use pattern in geriatric patients at a primary care facility in Bandung, Indonesia, using WHO indicators. This research was conducted using cross sectional design with retrospective data collection. Medical presciption from geriatric patients aged 60-74 years old visiting primary care facility during 2013-2015 were selected. A total of 103.292 prescriptions were obtained in this study. The average number of drugs per encounter was 2.1 (optimal range=1.6-1.8). Vast majority (99.41%) of the drugs prescribed were generic drugs (optimal value=100%). The encounters with an antibiotics prescribed were 7.4% (optimal range=20.0-26.8%). Very few parenteral drugs were prescribed in this study setting (0.04%) (optimal range=13.4-24.1%). The drugs prescribed from essential drug list were 72.83% (optimal value=100%). The most commonly prescribed drugs were paracetamol 500 mg, chlorpheniramine maleat 4 mg, amlodipine 5 mg, vitamin B complex, and glyceryl guaiacolat. The most frequently prescribed antibiotics were amoxicillin, cloramphenicol, cyprofloxacin, clindamycin, and oxytetracyclin. In conclusion, the medication use pattern in this study was below the WHO requirement. This finding called for a strategy to promote rational prescribing of medicines. Keywords: geriatrics, WHO prescribing indicators, drug use patterns

Development of Hypotonic Electrolyte Rehydration Drinks from Paneer and Cheese Whey

In the present study, development of electrolyte drinks from paneer and cheese whey was carried out by enzymatic hydrolysis of lactose to simple sugars and formulating the sugar to salt ratio to meet the World Health Organization (WHO) requirements (245 mOsmol/L) for Oral Rehydration Salt (ORS). Lactose hydrolyzed whey was diluted (1: 2.3 v/v) using potable quality demineralised water to achieve reduction in osmolarity of 75 mOsmol/L. The salt concentration was adjusted by adding 3.25 g sodium chloride and 0.8 g potassium chloride for paneer whey (per L) and 2.5 g sodium chloride, 0.9 g of potassium chloride and 1.5 g of trisodium citrate for cheese whey (per L) to meet Na, K and citrate levels in the resultant whey drink as per WHO requirement. Other additives used in developing hypotonic electrolyte whey drink from lactose hydrolyzed whey systems were sucralose (sweetener), citric acid (acidulant), orange flavour and orange colour. The formulated hypotonic electrolyte whey based drink had significantly higher sensory scores when compared to the scores of two commercial orange flavour ORS drinks. Cheese whey based electrolyte drink was superior over paneer whey based electrolyte drink in sensory characteristics; former drink had better consistency and mouth feel.

Cold Chain Medicines Storage Temperature Conformity by the World Health Organisation in Tanzania

A descriptive study on assessment of medicines cold chain storage conformity with World Health Organization (WHO) requirements in public health facilities was carried out in Dar es Salaam and Dodoma regions. Storage conformity in selected health facilities was assessed by monitoring temperature using temperature data loggers mounted in the refrigerators for a period of 30 days. Results indicated almost half of the health facilities 48.5% visited, did not significantly (P = 0.031) comply with storage temperature (+2°C to +8°C) as per WHO requirement because all recorded Mean Kinetic temperature (MKT) > 8°C. In rural areas, 59.2% of visited health facilities adhered to the WHO recommended storage temperature while in urban areas only 31.6% complied. The study has established electricity failure in urban and lack of gas in rural areas coupled with absence of contingency plan as major challenges to WHO temperature conformity in storage of cold chain medicines in health facilities in Tanzania.

BCS Biowaivers: Similarities and Differences Among EMA, FDA, and WHO Requirements.

The Biopharmaceutics Classification System (BCS), based on aqueous solubility and intestinal permeability, has enjoyed wide use since 1995 as a mechanism for waiving in vivo bioavailability and bioequivalence studies. In 2000, the US-FDA was the first regulatory agency to publish guidance for industry describing how to meet criteria for requesting a waiver of in vivo bioavailability and bioequivalence studies for highly soluble, highly permeable (BCS Class I) drugs. Subsequently, the World Health Organization (WHO) and European Medicines Agency (EMA) published guidelines recommending how to obtain BCS biowaivers for BCS Class III drugs (high solubility, low permeability), in addition to Class I drugs. In 2015, the US-FDA became better harmonized with the EMA and WHO following publication of two guidances for industry outlining criteria for obtaining BCS biowaivers for both Class I and Class III drugs. A detailed review and comparison of the BCS Class I and Class III criteria currently recommended by the US-FDA, EMA, and WHO revealed good convergence of the three agencies with respect to BCS biowaiver criteria. The comparison also suggested that, by applying the most conservative of the three jurisdictional approaches, it should be possible for a sponsor to design the same set of BCS biowaiver studies in preparing a submission for worldwide filing to satisfy US, European, and emerging market regulators. It is hoped that the availability of BCS Class I and Class III biowaivers in multiple jurisdictions will encourage more sponsors to request waivers of in vivo bioavailability/bioequivalence testing using the BCS approach.

Can r-graphene oxide replace the noble metals in SERS studies: the detection of acrylamide

Environmental context The need for detecting and sensing hazardous materials that can contaminate our food and water is growing each and every year. Regulation of these contaminants to safeguard human health depends on the ability to detect them at ultra-low concentrations in the environment. This work proposes a simple and efficient substrate preparation for detecting acrylamide, a toxic and carcinogenic material usually found in drinking water. Abstract Polyacrylamide acts as a very common water purifier worldwide. Unfortunately, it leaves hazardous and toxic residues of its monomer, acrylamide (C3H5NO), in water sources. The World Health Organization (WHO), the Food and Agriculture Organisation of the United Nations (FAO) and the European Union (EU) set the maximum contaminant level of acrylamide in drinking water to 0.1–0.5µgL–1. This environmental risk encouraged our efforts to develop surface-enhanced Raman spectroscopy (SERS) probes that are easy and simple to fabricate, and also have superb detection ability. We report down to 0.071µgL–1 acrylamide detection with good reproducibility, which is even lower than the WHO, FAO and EU requirements, and may be used as a powerful analytical alternative for detection. In this manuscript, we present a practical route to fabricate these detection substrates for detection of ultra-low concentrations of aqueous acrylamide solutions. The facile method is based on deposition of graphene oxide on Si wafers by ultrasonication, followed by surface reduction. These substrates require no adhesion layer or pretreatment with O2 plasma or aminopropyl triethoxysilane for the coating process. Sonochemical deposition of silver nanoparticles on the substrates is also carried out and the product compared with the proposed Si–reduced graphene oxide wafers.

Progress and challenges of clinical trials registration in Latin America and the Caribbean's

Clinical trial registries are one of the main sources of information concerning health research interventions that have been or are being carried out throughout the world. The World Health Organization (WHO) established a minimum data set to be recorded (20 items), which was agreed upon internationally with the stakeholders, and established a network of primary and associated records. In addition to the register ClinicalTrial.Gov (of the United States of America), there are currently two primary registries in the Americas (from Brazil and Cuba) that meet WHO requirements and provide data to WHO's International Clinical Trials Registry Platform (ICTRP). Furthermore, there are important advances in the region related to the regulations, development and implementation of national registries and to the support of the ethics committees and editors to this initiative.

Avances y retos en el registro de ensayos clínicos en américa Latina y el Caribe

Clinical trial registries are one of the main sources of information concerning health research interventions that have been or are being carried out throughout the world. The World Health Organization (WHO) established a minimum data set to be recorded (20 items), which was agreed upon internationally with the stakeholders, and established a network of primary and associated records. In addition to the register ClinicalTrial.Gov (of the United States of America), there are currently two primary registries in the Americas (from Brazil and Cuba) that meet WHO requirements and provide data to WHO’s International Clinical Trials Registry Platform (ICTRP). Furthermore, there are important advances in the region related to the regulations, development and implementation of national registries and to the support of the ethics committees and editors to this initiative.

Evaluation of the thermal stability of a novel strain of live-attenuated mumps vaccine (RS-12 strain) lyophilized in different stabilizers

The stability of live-attenuated viral vaccines is important for immunization efficacy. Here, the thermostabilities of lyophilized live-attenuated mumps vaccine formulations in two different stabilizers, a trehalose dihydrate-based stabilizer and a stabilizer containing sucrose, human serum albumin and sorbitol were investigated using accelerated stability tests at 4°C, 25°C and 37°C at time points between 4h (every 4h for the first 24h) and 1 week. Even under the harshest storage conditions of 37°C for 1 week, the 50% cell culture infective dose (CCID50) determined from titrations in Vero cells dropped by less than 10-fold using each stabilizer formulation and thus complied with the World Health Organization's requirements for the potency of live-attenuated mumps vaccines. However, as the half-life of the RS-12 strain mumps virus infectivity was lengthened substantially at elevated temperatures using the trehalose dihydrate (TD)-based stabilizer, this stabilizer is recommended for vaccine use.

Women, abortion and the new technical and policy guidance from WHO

The World Health Organization (WHO) has released an update of its 2003 publication Safe abortion: technical and policy guidance for health systems.1 The guidance contained in the original publication has been widely used by governments, nongovernmental organizations, providers of women’s health services and women’s health and human rights advocates. The updated guidance is thus certain to be well received and put to good use by all public health officials and medical personnel who care for women’s health and rights. The substantial revisions in the 2012 update reflect developments not only in safe abortion methods and clinical care, but also in the application of human rights principles in policy-making and in legislation related to induced abortion. The updated publication was prepared in accordance with WHO standards and requirements for evidence-based guideline development and the draft recommendations were reviewed and revised by an international panel of experts. Notably, these recommendations provide guidance about the range of safe options available to women seeking an elective abortion and highlight the importance of having the woman participate in the choice of abortion method, pain control and post-abortion contraception. Some women will obviously always refuse to have an induced abortion, a subject that has sparked heated controversy in every epoch and continues to do so today. However, exposure to unsafe abortion is gravely detrimental to women’s health and human rights. At present, an estimated 22 million abortions continue to be performed annually under unsafe conditions throughout the world. About 47 000 women die every year from the complications of these unsafe abortions and an additional 5 million are left disabled.2 Access to safe elective abortion early in pregnancy could prevent nearly every one of these deaths and cases of disability. Women throughout history have resorted to induced abortion to deal with unwanted pregnancy, but often at risk to their health or even their lives. Although use of contraceptives has resulted in decreased rates of unintended pregnancy, it has not eliminated the need for safe elective abortion because every method of contraception has an intrinsic failure rate, even if used strictly as prescribed. According to estimates based on 2007 data on contraceptive use and failure rates, every year approximately 33 million women worldwide get pregnant accidentally while practising contraception.1 Unsafe induced abortion is not only a public health problem; it is also a human rights issue.3 Governments are obligated by their national constitutions or by legally binding international human rights conventions to protect a set of fundamental human rights, namely, the right to the highest attainable standard of health; to non-discrimination; to life, liberty and personal security; to education and information, and to freedom from inhuman and degrading treatment. WHO’s 2012 guidance explains how national courts and regional and international human rights bodies, including the United Nations treaty monitoring bodies, have increasingly applied human rights principles to facilitate women’s transparent access to safe abortion services.1 As unsafe elective abortion is a multifaceted problem involving politicians, lawyers, religious groups and medical staff, addressing the human rights of women who face an unplanned pregnancy may facilitate helpful dialogue among these stakeholders. In a consensus statement issued in 1999, the United Nations General Assembly prescribed that “in circumstances where abortion is not against the law, health systems should train and equip health-service providers and should take other measures to ensure that such abortion is safe and accessible”.4 Restrictive abortion laws are not associated with lower abortion rates.5 In countries where induced abortion is highly restricted by law, safe abortion has frequently become the privilege of the rich, while poor women are left with little choice but to resort to unsafe providers. Even in places where abortion is allowed only to save a woman’s life or to protect her health, trained providers and good services and treatments must be made available to manage the complications of unsafe abortion. In updating its guidance on safe abortion, WHO, with support from an international consensus and prompted by human rights obligations, has responded to a major neglected public health need of women. The writers of this editorial, a health professional and a lawyer, submit that until abortion is decriminalized, the tragedy of unsafe abortion will continue to haunt us and to threaten the life, health and rights of women. Furthermore, research aimed at developing simpler, improved methods for performing induced abortion has the potential to save the lives of millions of women globally.

Water quality assessment of streams draining the Akwapim Ridge of Ghana

Surface water samples from seven streams on the Akwapim Ridge were analysed over a period of 1 year for various water quality parameters following standard methods prescribed in APHA, AWWA, WEF and AOAC. The study was carried out in order to assess the suitability of the streams for drinking and other domestic purposes. Additionally, the effect of land use activities was assessed. The study revealed that, generally, most of the physico-chemical parameters of the streams were below the World Health Organization (WHO) limits recommended for drinking water, with the exception of the levels of sulphate and conductivity in three of the streams (Opiafo: 224 mg/1, 908.5 iS/cm; Kwati: 221.3 mg/1, 920 iS/cm; and Ademi: 246 mg/1, 1292 iS/cm), respectively, which were above the WHO requirements. Nevertheless, taking these factors into consideration (except the sulphate and conductivity), the waters may be regarded as excellent and good for drinking and other domestic uses.

Licensed Vaccines

The cell substrate, virus strain, route of administration, and safety of the rubella vaccines were all considered given the experience with other vaccines. Tissues from closed colonies of ducks, rabbits, and quails-in addition to human diploid cells-are now well established as suitable substrates. Production of rubella vaccine is now based on the principle that the vaccine virus is a live attenuated strain. RA27/3, Cendehill, Takahashi, Matsuura, and HPV-77 were initially licensed in 1969-1970; HPV-77 grown in dog kidney cells has since been withdrawn. The subcutaneous route of administration is the most acceptable. Safe and effective vaccines include RA27/3 and Cendehill, which are widely available, and five other vaccines grown in two tissues available only in Japan. The key issue is the extent to which the vaccines should be used alone or together with other vaccines in individual countries. The World Health Organization's requirements for the vaccines, first formulated in 1976, are open to revision. These requirements did not include a test for stability, which will be especially pertinent in the developing world.